1. Genetic: you are born with certain predispositions
2. Environmental: where you were born and choose to live matters…if you don’t have clean drinking water, you will have a very difficult time staying healthy
3. Physical: your fitness, habits and hygiene play large roles
4. Psychological: the amount of stress you carry can make you ill

All of these elements operate from the patient’s standpoint. They basically have the same impact whether you live in Tokyo or a remote part of India. But the types of diseases vary by region and by levels of affluence. I have been to parts of the Middle East where the attitude is almost that if you don’t have diabetes, you are not fully participating in life. Given these commonalities, if you can fix healthcare problems at the bottom of the pyramid, you can learn how to lower the costs of providing healthcare solutions in developed nations too.

In both poor and affluent communities, healthcare costs swell because people don’t seek care early enough. Whether you ignore chest pains or an infection for too long, either way the cost of treatment will be exponentially higher than if you intervened early.

From a health information system standpoint, we need to think differently about how we identify, solve and treat healthcare problems. Most software systems in the healthcare world largely deal with transactions. They store medical records, lab results, and the like. This is very basic stuff, and not nearly the end goal.

In the future, the success of medical software anywhere in the world will hinge on its ability to proactively manage three things:

1. Disease
2. Diagnosis
3. Cure

For example, long before many diseases become critical (i.e., expensive to treat), there are changes within a person’s body and sometimes behavior. These changes are data. In fact, our bodies generate huge amounts of data, the vast majority of which our information systems ignore, until a disease reaches an expensive/critical stage. But the technology now exists to gather much of this data remotely – from lab-on-a-chip devices to medical tricorders. All we need is our systems to utilize this data properly.

To put this in simple terms, your physician should be able to alert you – not the other way around – when your body starts producing data of concern.

Now think back to the challenges of the poor. The greater our ability to remotely – and cost efficiently – monitor and treat a patient, the better our ability to lower healthcare costs worldwide. A physician in Manhattan or Mumbai should be able to help a patient in the middle of a poor, remote village…without ever leaving his or her office. This would greatly improve what we can do locally.

Medicine will always be about compassion and humans caring for humans, but we can’t deny that medicine has already also become a data science. We shouldn’t think about this in terms of one approach for the poor and another for the wealthy. We need to recognize that caring for the poor may benefit the wealthy more than they can possibly imagine today.

It’s more complicated to create an engaging app than many business managers expect, especially in healthcare, one of the most complex industries. There are often different, opposing forces at work that make the task more challenging.

Your odds of an excellent outcome increase significantly if you keep one word in mind: prioritization.

In other words, deeply understanding a user’s priorities based on a changing context makes all the difference. What’s important enough to motivate a user to launch your app and to do so regularly? Does your approach make the user’s life easier, or does your interface baffle and confuse them?

You can think about the right prioritization at various levels:

– What are the user’s priorities when using the app and how do they change based on the context of use? For example, a patient’s priorities would be different before a medical procedure than after recovery.

– What information has the highest priority to the user at any given stage within the app? The first time someone uses an app to monitor their body mass index, the label “BMI” might have as much importance as the result, say 32 (moderately obese). But once the user gets used to the app, the reading needs to be much bigger than the label, if the label exists at all.

– What are the differences in priorities between the users and the sponsors (i.e., funders) of an app? To illustrate this point, I’ll tell you a story.

Many of our clients are administrators within healthcare organizations and one of their key priorities is productivity. There are good reasons for this: they don’t want patients to endure lengthy wait times, they need to manage operational costs, and seek to amortize fixed costs of expensive medical equipment.

But the users of many hospital apps are physicians, and their priority is quality. They want to know how their patients are doing, whether recovery is on track, and to be alerted immediately if there is a problem.

Too often, healthcare app developers fail to reconcile these different priorities in advance, and thus they build apps that no one uses. Before you start building an app, you need to strike a healthy balance among these potentially conflicting priorities.

For example, your app can identify and provide key metrics that are important to physicians – this will spur physician adoption and use. You can use timely push notifications for productivity alerts that can address key concerns of administrators. One possibility is to alert in real-time when a physician’s schedule falls behind a certain productivity threshold (e.g. waiting time has exceeded 45 minutes). This doesn’t require a lengthy report or a separate interface, a simple prod is enough – doing so is also more respectful of the user.

In app development, simple details make a big difference and managing them helps you prioritize the right information. Instead of adding screen after screen to signify problem areas, you can simply change the color of the data to red (e.g. a high BP of 140/100) at the right time, or provide haptic feedback when a finger touches the information.